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LIFELINE QUESTION STEPS
STEP 1: Contact Information
STEP 2 / 3: Patient Summary
STEP 4: Medical History
STEP 5: Health Chronology

LifeXtra Program Information and Steps to Register

The Information Guide will introduce you to the LifeXtra Questionaire and help you address the unique opportunities that exist for you as a potential participant in CHIPSA health care services.

LifeXtra Care and the Questionaire and Registration Information provide the unique opportunity for you to participate as a future recipient of valuable CHIPSA medical care. We encourage you to browse the links in this section to access an affordable health care and information service. You will find answers about health matters, how to learn more about enlisting and and register in a new affordable LifeXtra Care Program.


How Do I Use The LifeXtra Questionaire Information Guide?
We simply ask you to begin organizing your thoughts and experiences concerning your medical condition or the condition of a spouse or family member. We help you by presenting you with a series of questions designed to address some unknown experience, issues, responses or symptoms. There is no right way or wrong way to use the LifeXtra Questionaire / Information Guide, so it's helpful to not judge your answers to questions.

Please address a 'seperate questionaire' for each individual member. As you answer the LifeXtra Questionaire, you'll notice we left plenty of space for you to detail your responses to questions. Your responses will be personal windows into all of the elements that shape the way you make decisions—your current treatment regimen, emotions, your family members and how your physicians play a central role in decisions. That's why it's important for you to understand how each of these questions weighs on the treatment decisions you make.

At the end of this step -by-step exercise, you'll have more knowledge you require to measure your treatment expectations and provide our physicians information and criteria to develop an effective medical protocol to attend CHIPSA. You may not have the time or the energy to complete the LifeXtra Questionaire and Guide in one sitting. Don't worry, we made this tool simple step-by-step and flexible to support yours and our combined need to address your condition. If you're tired or you feel like you need to take a break, simply complete any STEP 1 thru 5 that you have begun and then return to the remaining steps later when you're refreshed.

The LifeXtra Questionaire: Five Basic Steps


STEP ONE asks you to take a moment to provide us your contact preference (name, email, phone etc.) and help us better understand your condition. (If you've already registered for admission or filled out a CHIPSA on-line inquiry, your identity will be respected with special care. You should complete the LifeXtra Questionnaire steps once you begin, before proceding on to other steps.

STEP TWO & THREE asks you to identify 'health preferences' and treatment as you determine 'how and why' criteria toward medical treatment, facilities, physicians which helps us begin authorized patient summary review of your health history. These two step asks you to identify decision-lifestyle influencers (such as; dental, allergies, diet, herbal supplements, etc.) and points to any additional family information you may have encountered during your search for the best medical care.

STEP FOUR is your opportunity to list your personal medical history, current medications, physician treatment concerns and the protocols upon which you wish to focus your expectations. This is NOT a medical record request.

STEP FIVE asks you to walk through a chronology of your health and your reciprocal medical care as you understand. We request that you provide us with an optional 'chronology essay' in further review of your medical condition, as we decide together to complete health history before you receive care at CHIPSA. Your chronology is important disclosure in providing our physicians understanding of your medical history, but also it provides you a method to gather strength for your healing path.






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